Healthcare Provider Details

I. General information

NPI: 1215505946
Provider Name (Legal Business Name): ASHLEY HEALTHCARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2021
Last Update Date: 06/17/2021
Certification Date: 06/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 E WALLACE ST
ASHLEY MI
48806-9616
US

IV. Provider business mailing address

30700 TELEGRAPH RD STE 2504
BINGHAM FARMS MI
48025-4571
US

V. Phone/Fax

Practice location:
  • Phone: 989-847-2011
  • Fax:
Mailing address:
  • Phone: 248-593-1990
  • Fax: 248-593-9120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: FAHIM UDDIN
Title or Position: MEMBER
Credential:
Phone: 248-593-1990